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Kip!I FE RIVER REQUESTED <br /> 2:00 23 <br /> REQUESTED DELIVERY 1 <br /> TIME: 12:00 <br /> AN MDU RESOURCES COMPANY STOCKTON ORDER NUMBER: 55020 <br /> Billing OFFICE (209) 933-6980 TICKET NUMBER: 1100311 <br /> www.kniferiver.com Dispatch: (800) 464-6572 / (209) 933-6999 <br /> CYDS DEL: 6.00 <br /> Safety First! P.O. BOX 66001, Stockton, CA 95206 LOAD#: 1 <br /> TRUCK ID DRIVER PLANT ID LEAVE P NT ARRIVE JO START POUR ENDRGURI LEAVE JOB I AT PLANT <br /> 5503421581 SHAWN KEITH STOCK j.''. % � . <br /> CUSTOMER ACCT ID CUSTOMER P.O./PROJECT NO. PROJECT NAME LOT&BLOCK PREVIOUS TRUCK <br /> 378044 / <br /> ;OLD TO: DELIVERY ADDRESS/LOCATION: ADDRESS VERIFIED? Check <br /> VALLEY DRILLING VALLEY; 23591 NORTH TRETHEWAY R <br /> ACAMPO <br /> 4DDITIONAL DELIVERY INSTRUCTIONS: DRUM REVOLUTIONS <br /> -/S MAYER RD, PREPAID CC <br /> BEGINNING ENDING TOTAL <br /> aty this Load Qty Ordered Qty Dlvd Product Code Product Description- UOM Unit Price EXT Amount <br /> 6.00 6. 00 6.00 504 10.3 SK. SAND SLURRY yd 192.50 1, 155.0( <br /> 1.00 554015 FUEL SURCHARGE EA 40. 00 40.00 <br /> 6.00 55EFS CEMENT FREIGHT SURCHARGE CY 10. 00 60.00 <br /> WATER ADDED/ESTIMATED SLUMP STANDBY AND UNLOADING TIME OVERTIME MINUTES SUB TOTAL 1,255.00 <br /> =ull Load: GAL SLUMP Excess truck time will be assessed by dispatch at the current SALES TAX $97.26 <br /> ?/3 Load: GAL SLUMP rate per minute for orders exceeding five(5)minutes per ADDITIONAL TIME FEE TICKET TOTAL $1,352.26 <br /> L/3 Load: GAL SLUMP cubic yard. GRAND TOTAL $1,352.26 <br /> DESIGN SLUMP REQUESTED SLUMP ACKNOWLEDGEMENT OF R EIPT,WATER ADDED,&TERMS AND CONDITIONS ON WEB SITE <br /> 0.00 6.00 <br /> Signature: I�G lnl ` � Printed Name: <br /> USE OF CONCRETE,AS PLACED: RELEASE:Contractor or Owners ag ee to in emnify and save harmless Knife River Corporation from liability imposed as a <br /> result of any damage caused to the property of others as a result of such delivery.FOR ADDITIONAL RELEASE <br /> INFORMATION:SEE WWW.KNIFERIVER.COM/NCA FOR PROP 65 INFO WWW.P65WARNINGS.CA.GOV <br /> 'ESTED BY AIR/SLUMP/TEMP/CYL'S <br /> Signature: Printed Name: <br /> (rife River Weighmaster Certificate <br /> 'HIS IS TO CERTIFY that the following described commodity was weighed, measured or counted by a weighmaster, <br /> chose signature is on the certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 <br /> ;commencing with section 12700) of Division 5 of the California Business and Professional Code, administered by <br /> :he Division of Measurement Standards of the California Department of Food and Agriculture. <br /> Deputy <br /> ruck Driver User Disp Ticket Num Ticket ID Time Date <br /> 50342158 46625 user 1100311 128120 11 : 38 5/24/23 <br /> Dad Size Mix Code Returned Qty Mix Age Seq Load ID <br /> . 00 CYDB 504 D 47 <br /> terial Design Qty Required Batched %Var%Moisture Actual Wat Tot.Wat Trim <br /> PEII-V 968.0 Ib 5808.0 Ib 5920.0 Ib 1.93% <br /> .ND 1936 Ib 12104 Ib 12080 Ib -0.19% 4.20%A 487 Ib 692 <br /> FY 609 Ib 1914 Ib 1900 Ib -0.74% 1900 Ib 1900 -25.00 gl <br /> tual Num Batches: 1 <br /> 3d 19900 Ib Design WIC: 0.629 Water/Cement: 0.617 T Design 3653.5 Ib Actual 2386.6 Ib To Add: 1266.9 Ib <br /> imp: 6.00 in # Water in Truck: 0.0 gl Adjust Water: 0.0 gl /Load Trim Water: -25.0 gl / CYDS <br />